Correlations between the abnormal development of the skull base and facial skeleton growth in anterior synostotic plagiocephaly: the predictive value of a classification based on CT scan examination.

BACKGROUND: Anterior cranial plagiocephaly, depending on the early hemicoronal suture fusion, is the most relevant form of plagiocephaly in terms of clinical implications. Its estimated incidence ranges between 0.4 and 1 per 1,000 live births. In the present report, we aim at validating the classification of Di Rocco and Velardi, proposing a scheme based on basicranium analysis using CT scans and its predictive value by evaluating the developmental characteristics of a population of adult subjects affected by anterior plagiocephaly who had underwent the surgical correction in the first months of life.
MATERIALS AND METHODS: The group of patients here considered was retrieved from among all patients operated upon for craniostenosis in the pediatric neurosurgery unit of Policlinico Gemelli in Rome between January 1, 1980 and December 31, 1989. The study group consisted of 13 patients, seven females and six males, affected by anterior synostotic plagiocephaly ranging in age between 20 and 32 years (mean 25.54 years). We also formed a group of unaffected patients in order to control for normal variability in the population. The subjects of the study group were evaluated using CT scan exams and cephalometric analyses were performed using three-dimensional reconstruction. DISCUSSION AND
CONCLUSION: In this study, we were able to associate a facial phenotype to confirm the predictive value of the classification proposed. It is highly probable that the different outcomes depend on the different degrees of involvement in the synostotic process by the various skull base sutures which were essentially unaffected by the surgical procedures.